Abstract
PURPOSE: To evaluate the relationships between the sperm DNA fragmentation index (DFI) and semen parameters and its application in fresh embryos via in vitro fertilization and transfer. METHODS: A retrospective propensity score matching (PSM) study was conducted on 162 cycles of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and fresh embryo transfer (fresh IVF/ICSI-ET) from 2020-2024. RESULTS: Spearman correlation analysis revealed a negative correlation between the sperm DFI and sperm motility (r = -0.44, p = 3.32e-08), forward movement of sperm (r = -0.46, p = 3.25e-09), and normal morphology of sperm (r = -0.25, p = 0.000); there was no correlation between the sperm DFI and male age (r = 0.08, p = 0.31), semen volume (r = -0.15, p = 0.05), sperm concentration (r = -0.16, p = 0.32), or male body mass index (BMI) (r = 0.02, p = 0.98). There were no significant differences in the 2PN fertilization rate (64.98% vs. 67.18%, p = 0.362), D3 high-quality embryo rate (28.34% vs. 23.91%, p = 0.107), biochemical pregnancy rate (71.60% vs. 71.60%, p = 1), clinical pregnancy rate (65.00% vs. 65.00%, p = 1), delivery rate (50.72% vs. 48.44%, p = 0.928), miscarriage rate (7.25% vs. 6.25%, p = 1), or singleton birth weight (3,350 g vs. 3,200 g, p = 0.599) between the normal DFI (DFI < 30%) group and the high DFI (DFI ≥ 30%) group. CONCLUSION: Sperm DFI is weakly associated with sperm motility, forward movement, and normal sperm morphology, and the correlations are not strong. However, there is no correlation between the sperm DFI and the clinical outcomes of fresh IVF/ICSI-ET.